Autonomous Artificial Intelligence vs Artificial Intelligence–Assisted Human Optical Diagnosis of Colorectal Polyps: A Randomized Controlled Trial
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Date
2024
Authors
Roupen Djinbachian,1,2,* Claire Haumesser,1,* Mahsa Taghiakbari,1,2 Heiko Pohl,3,4 Alan Barkun,5 Sacha Sidani,2 Jeremy Liu Chen Kiow,2 Benoit Panzini,2 Simon Bouchard,2 Erik Deslandres,2 Abla Alj,6 and Daniel von Renteln1,2
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Abstract
BACKGROUND & AIMS: Artificial intelligence (AI)–based
optical diagnosis systems (CADx) have been developed to
allow pathology prediction of colorectal polyps during colo
noscopies. However, CADx systems have not yet been vali
dated for autonomous performance. Therefore, we conducted
a trial comparing autonomous AI to AI-assisted human (AI-H)
optical diagnosis. METHODS: We performed a randomized
noninferiority trial of patients undergoing elective colonos
copies at 1 academic institution. Patients were randomized
into (1) autonomous AI-based CADx optical diagnosis of
diminutive polyps without human input or (2) diagnosis by
endoscopists who performed optical diagnosis of diminutive
polyps after seeing the real-time CADx diagnosis. The primary
outcome was accuracy in optical diagnosis in both arms using
pathology as the gold standard. Secondary outcomes included